Posters

Femtosecond-laser assisted astigmatic keratotomies at the time of cataract surgery: visual and astigmatic outcomes

Poster Details

First Author: D.Ramanathan UK

Co Author(s):    M. Laginaf   T. Poole                 

Abstract Details

Purpose:

To evaluate Femtosecond-laser assisted astigmatic keratotomies (Femto-AKs) as a means of correcting astigmatism at the time of cataract surgery.

Setting:

Eye Treatment Centre. Frimley Park Hospital NHS Foundation Trust, Camberley. England. UK.

Methods:

A retrospective study of Femto-AK outcomes was performed between October 2018 and 2019. 185 eyes were identified, of which post-operative refractive and visual data was available for 95 eyes of 88 patients. Femto-AKs were completed using Victus Femtosecond-laser Platform (Bausch and Lomb) following capsulotomy and nucleus fragmentation. The 0° and 180° meridians were marked preoperatively at the slit-lamp. Femto-AKs were paired, of 80% stromal depth as guided by live optical coherence tomography, with an 8.5mm diameter, and AK length predefined using a modified Hoffman nomogram. Femto-AK cuts were manually opened during surgery and topical Levofloxacin prescribed post-operatively for 4 weeks.

Results:

The average age of the cohort was 76 years (47-95). Mean preoperative delta-K was 1.54 dioptres (D) (0.63- 3.4D). The preoperative axis distribution of delta-K was: 27 eyes with-the-rule astigmatism, 57 against-the-rule astigmatism and 11 oblique astigmatism. Mean Femto-AK length was 42.8 degrees (30°-57°). There were no intraoperative complications. Post-operative refraction was carried out using autorefraction in 51% of patients and subjective refraction in 49%. Mean post-operative unaided visual acuity, without excluding eyes with comorbidities, was 0.22 logMAR (-0.20- 0.80). Mean post-operative refractive cylinder was 0.88D (0.0- 2.5D). Eight eyes had a reversal of axis following treatment.

Conclusions:

Femtosecond-laser assisted astigmatic keratotomies provide safe and simple surgical correction of low to moderate corneal astigmatism with promising outcomes. Our nomogram is conservative and could be enhanced.

Financial Disclosure:

receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented